How much rates vary
Facilitymedian $4,677 · 10th to 90th $501 to $24,547Professionalmedian $1,096 · 10th to 90th $155 to $2,138
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,096.48 Median $6,025.60 Typical High $15,135.61 | Facility | None | $1,096.48 | $6,025.60 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,230.27 | $2,137.96 |
AvMed Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,023.29 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,754.23 | Professional | None | $977.24 | $1,348.96 | $2,754.23 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,412.54 | Professional | None | $891.25 | $954.99 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $933.25 Typical High $1,995.26 | Professional | None | $147.91 | $933.25 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $15,488.17 | Facility | None | $1,584.89 | $4,073.80 | $15,488.17 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,479.11 Typical High $2,884.03 | Professional | None | $60.26 | $1,479.11 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $562.34 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $223.87 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $1,023.29 |
Where Florida sits
The same service costs 13.5 times more in Maine than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $34,179TX $2,531
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.